Implication of diabetic status on platelet reactivity and clinical outcomes after drug-eluting stent implantation: results from the PTRG-DES consortium
Authors' conclusion
The levels of on-clopidogrel platelet reactivity are determined by diabetic status and the severity of DM. In addition, HPR phenotype significantly increases the risk of MACCE only in diabetic patients.
Study context
- Population
- Drug-eluting stent (DES)-treated patients with available platelet function test (PFT) on dual antiplatelet therapy including clopidogrel, July 2003–Aug 2018
- Participants
- 11,714 patients
- Exposure
- Diabetes mellitus (DM) vs non-DM
- Outcome
- Platelet reactivity (VerifyNow PRU; HPR ≥ 252 PRU) and MACCE (all-cause death, MI, stent thrombosis or stroke)
Methodological detailsPTRG-PFT cohort, PTRG-DES consortium
- PTRG-PFT cohort, PTRG-DES consortium
Main finding
As reported in the abstract
Platelet reactivity
P < 0.001
Observational data: associations, not effects.
Further findings
Prevalence of HPR
P < 0.001
| Outcome | HRadj (95% CI) | P value | |
|---|---|---|---|
| MACCE with HPRvs no HPR, non-DMnon-DM | 1.073 (0.869–1.325) | P = 0.511 | |
| MACCE with HPRvs no HPR, DMDM | 1.507 (1.193–1.902) | P < 0.001 | |
| 0.512Adjusted hazard ratio (log scale) |
Prevalence of high platelet reactivity (HPR)
- P2Y12 reaction unit (PRU) level and HPR prevalence significantly associated with insulin requirement and HbA1c level, as well as diabetic status
Major adverse cardiac and cerebrovascular event (MACCE) with HPR vs no HPR, DM
- DM status and HPR showed synergistic clinical impact on MACCE
Original publication
Implication of diabetic status on platelet reactivity and clinical outcomes after drug-eluting stent implantation: results from the PTRG-DES consortium. Cardiovasc Diabetol. Published 7 September 2023. doi:10.
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